• Title/Summary/Keyword: 위험계획

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Comparisons between the Two Dose Profiles Extracted from Leksell GammaPlan and Calculated by Variable Ellipsoid Modeling Technique (렉셀 감마플랜(LGP)에서 추출된 선량 분포와 가변 타원체 모형화기술(VEMT)에 의해 계산된 선량 분포 사이의 비교)

  • Hur, Beong Ik
    • Journal of the Korean Society of Radiology
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    • v.11 no.1
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    • pp.9-17
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    • 2017
  • A high degree of precision and accuracy in Gamma Knife Radiosurgery(GKRS) is a fundamental requirement for therapeutical success. Elaborate radiation delivery and dose gradients with the steep fall-off of radiation are clinically applied thus necessitating a dedicated Quality Assurance(QA) program in order to guarantee dosimetric and geometric accuracy and reduce all the risk factors that can occur in GKRS. In this study, as a part of QA we verified the accuracy of single-shot dose profiles used in the algorithm of Gamma Knife Perfexion(PFX) treatment planning system employing Variable Ellipsoid Modeling Technique(VEMT). We evaluated the dose distributions of single-shots in a spherical ABC phantom with diameter 160 mm on Gamma Knife PFX. The single-shots were directed to the center of ABC phantom. Collimating configurations of 4, 8, and 16 mm sizes along x, y, and z axes were studied. Gamma Knife PFX treatment planning system being used in GKRS is called Leksell GammaPlan(LGP) ver 10.1.1. From the verification like this, the accuracy of GKRS will be doubled. Then the clinical application must be finally performed based on precision and accuracy of GKRS. Specifically the width at the 50% isodose level, that is, Full-Width-of-Half-Maximum(FWHM) was verified under such conditions that a patient's head is simulated as a sphere with diameter 160mm. All the data about dose profiles along x, y, and z axes predicted through VEMT were excellently consistent with dose profiles from LGP within specifications(${\leq}1mm$ at 50% isodose level) except for a little difference of FWHM and PENUMBRA(isodose level: 20%~80%) along z axis for 4 mm and 8mm collimating configurations. The maximum discrepancy of FWHM was less than 2.3% at all collimating configurations. The maximum discrepancy of PENUMBRA was given for the 8 mm collimator along z axis. The difference of FWHM and PENUMBRA in the dose distributions obtained with VEMT and LGP is too small to give the clinical significance in GKRS. The results of this study are considered as a reference for medical physicists involved in GKRS in the whole world. Therefore we can work to confirm the validity of dose distributions for all collimating configurations determined through the regular preventative maintenance program using the independent verification method VEMT for the results of LGP and clinically assure the perfect treatment for patients of GKRS. Thus the use of VEMT is expected that it will be a part of QA that can verify and operate the system safely.

Strategies for Public Health Service Development in the Times of Local Autonomy (지방자치시대의 공공보건사업 발전 전략)

  • 박정한
    • Health Policy and Management
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    • v.12 no.3
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    • pp.1-22
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    • 2002
  • Health is a fundamental human right and a sine qua non for happiness of people and for national development. Government has a responsibility for the provision of health services for their people. Recent changes of disease pattern, i.e. decrease of Infectious diseases and increase of chronic and degenerative diseases Including cancer and cardiovascular diseases, together with universal coverage of health insurance and improved living standard have prompted medical care utilization and skyrocketed the national health expenses. The goal of national health policy is improving the quality of life through the betterment of health level. To achieve this goal it is necessary to establish a healthcare system for lifetime, to improve the efficiency of healthcare delivery system, and to strengthen the public health services for disease prevention and health promotion. The current public health service programs are Inefficient due to an inconsistent policy for health service program, lack of health information system, irrational health program planning and evaluation, and Inadequate training of health workers. Local government has a legal responsibility for health service program planning and promoting the competence of health workers. Thus, municipal and provincial health departments should expand their roles and strengthen their function. The strategies for developing public health service programs at local level are ${\circled}1$ stipulating the goals of health policy, ${\circled}2$ promoting the ability for health program planning and evaluation, ${\circled}3$ establishing health information and surveillance system, ${\circled}4$ training of health workers, ${\circled}5$ establishing an institution for health information management and training of health workers, and ${\circled}61$ collaboration with local universities.

Microbiological Hazard Analysis and Verification of Critical Control Point (CCP) in a Fresh-Cut Produce Processing Plant -Case Study of a Fresh-Cut Leaf Processing Plant- (신선편이 농산물 가공업체의 미생물학적 위해 요소 분석 및 중점 관리 지점(CCP)의 검증 -신선편이 엽채류 가공업체를 대상으로-)

  • Kim, Su-Jin;Sun, Shih-Hui;Min, Kyung-Jin;Yoon, Ki-Sun
    • Journal of the East Asian Society of Dietary Life
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    • v.21 no.3
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    • pp.392-400
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    • 2011
  • The objectives of this study were to analyze environmental microbial contamination levels by sampling the surfaces of processing lines and equipment and to verify CCPs of the HACCP plan in a fresh-cut produce processing plant The level of airborne microorganisms in the processing plant was $10^1$ log CFU/plate/15min. Total plate counts and coliform groups of the processing facilities were 1~2 log CFU/100 $cm^2$. No E. coli or S. aureus were detected in the processing plant. However, total plate counts on the cutting board for raw materials and on the spin-dryer were $4.20{\pm}2.12$ log CFU/$cm^2$ and $4.57{\pm}0.92$ log CFU/$cm^2$, respectively. These levels were higher than the safe microbial level, and therefore, the chance of cross-contamination during processing was increased. According to the results of microbiological analyses, total aerobic bacteria and coliform groups of the samples were increased after the second washing and spin-drying steps, due to cross-contamination from the spin-dryer. Thus, an effective method that can be used for microbial control during the washing and drying steps is needed for microbial control in fresh-cut produce processing plants. The results of a verification study also suggest that modification of the HACCP plan is needed along with additional CPs, which were identified as a second washing, spin drying, and the cold storage of final products.

Optimization of Supercritical Water Oxidation(SCWO) Process for Decomposing Nitromethane (Nitromethane 분해를 위한 초임계수 산화(SCWO) 공정 최적화)

  • Han, Joo Hee;Jeong, Chang Mo;Do, Seung Hoe;Han, Kee Do;Sin, Yeong Ho
    • Korean Chemical Engineering Research
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    • v.44 no.6
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    • pp.659-668
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    • 2006
  • The optimization of supercritical water oxidation (SCWO) process for decomposing nitromethane was studied by means of a design of experiments. The optimum operating region for the SCWO process to minimize COD and T-N of treated water was obtained in a lab scale unit. The authors had compared the results from a SCWO pilot plant with those from a lab scale system to explore the problems of scale-up of SCWO process. The COD and T-N in treated waters were selected as key process output variables (KPOV) for optimization, and the reaction temperature (Temp) and the mole ratio of nitromethane to ammonium hydroxide (NAR) were selected as key process input variables (KPIV) through the preliminary tests. The central composite design as a statistical design of experiments was applied to the optimization, and the experimental results were analyzed by means of the response surface method. From the main effects analysis, it was declared that COD of treated water steeply decreased with increasing Temp but slightly decreased with an increase in NAR, and T-N decreased with increasing both Temp and NAR. At lower Temp as $420{\sim}430^{\circ}C$, the T-N steeply decreased with an increase in NAR, however its variation was negligible at higher Temp above $450^{\circ}C$. The regression equations for COD and T-N were obtained as quadratic models with coded Temp and NAR, and they were confirmed with coefficient of determination ($r^2$) and normality of standardized residuals. The optimum operating region was defined as Temp $450-460^{\circ}C$ and NAR 1.03-1.08 by the intersection area of COD < 2 mg/L and T-N < 40 mg/L with regression equations and considering corrosion prevention. To confirm the optimization results and investigate the scale-up problems of SCWO process, the nitromethane was decomposed in a pilot plant. The experimental results from a SCWO pilot plant were compared with regression equations of COD and T-N, respectively. The results of COD and T-N from a pilot plant could be predicted well with regression equations which were derived in a lab scale SCWO system, although the errors of pilot plant data were larger than lab ones. The predictabilities were confirmed by the parity plots and the normality analyses of standardized residuals.

A Study on the Current State of the Integrated Human Rights of the Elderly in Rural Areas of South Korea (농촌지역 거주 노인의 통합적 인권보장 실태에 관한 연구)

  • Ahn, Joonhee;Kim, MeeHye;Chung, SoonDool;Kim, SooJin
    • 한국노년학
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    • v.38 no.3
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    • pp.569-592
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    • 2018
  • This study purported to investigate the current state of human rights of older adults residing in rural areas of Korea. The study utilized, as an analytic framework, 4 priority directions (1. "older persons and development", 2. "rural area development", 3. "advancing health and well-being into old age", and 4. "ensuring enabling and supportive environments") with 13 task actions recommended by Madrid International Plan of Action on Ageing (MIPAA). Furthermore, the study examined gender differences in all items included in the analytic framework. Data was collected by the face-to-face survey on 800 subjects aged 65 and over. Statistical analyses were conducted using STATA 13.0 program. The main results were summarized in order of 4 priority directions as follows. First, average working hours per day were 6.2, and men reportedly participated in economic activities and needed job training more than women, while women participated in lifelong education programs more than men. Awareness of fire and disaster prevention facilities was low in both genders. Second, accessibility to the support center for the elderly living alone as well as protective services for the vulnerable elderly was found to be low. IT-based services and networking were used more by men than women, and specifically, IT-based financial transactions and welfare services were least used. Third, medical check-ups and vaccinations were well received, while consistent treatments for chronic illnesses and long-term care services were relatively less given. In addition, accessibility to mental health service centers was considerably low. Fourth, although old house structures and the lack of convenience facilities were found to be circumstantial risk factors for these elders, experiences of receiving housing support services were scarce. The elderly were found to rely more on informal care, and concerns for their care were higher in women than men. Plus, accessibility to elderly abuse services was markedly low. Based on these results, discussed were implications for implementing policies and practical interventions to raise the levels of the human rights for this population.

Rectal Bleeding and Its Management after Irradiation for Cervix Cancer (자궁경부암 환자에서 방사선치료 후에 발생한 직장출혈과 치료)

  • Chun Mison;Kang Seunghee;Kil Hoon-Jong;Oh Young-Taek;Sohn Jeong-Hye;Jung Hye-Young;Ryu Hee Suk;Lee Kwang-Jae
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.343-352
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    • 2002
  • Purpose : Radiotherapy is the main treatment modality for uterine cervix cancer. Since the rectum is in the radiation target volume, rectal bleeding is a common late side effect. This study evaluates the risk factors of radiation induced rectal bleeding and discusses its optimal management. Materials and Methods : total of 213 patients who completed external beam radiation therapy (EBRT) and intracavitary radiation (ICR) between September 1994 and December 1999 were included in this study. No patient had undergone concurrent chemo-radiotherapy. Ninety patients received radiotherapy according to a modified hyperfractionated schedule. A midline block was placed at a pelvic dose of between 30.6 Gy to 39.6 Gy. The total parametrial dose from the EBRT was 51 to 59 Gy depending on the extent of their disease. The Point A dose from the HDR brachytherapy was 28 Gy to 30 Gy $(4\;Gy\times7,\;or\;5\;Gy\times6)$. The rectal point dose was calculated either by the ICRU 38 guideline, or by anterior rectal wall point seen on radiographs, with barium contrast. Rectal bleeding was scored by the LENT/SOMA criteria. For the management of rectal bleeding, we opted for observation, sucralfate enema or coagulation based on the frequency or amount of bleeding. The median follow-up period was 39 months $(12\~86\;months)$. Results : The incidence of rectal bleeding was $12.7\%$ (27/213); graded as 1 in 9 patients, grade 2 in 16 and grade 3 in 2. The overall moderate and severe rectal complication rate was $8.5\%$. Most complications $(92.6\%)$ developed within 2 years following completion of radiotherapy (median 16 months). No patient progressed to rectal fistula or obstruction during the follow-up period. In the univariate analysis, three factors correlated with a high incidence of bleeding an icruCRBED greater than 100 Gy $(19.7\%\;vs.\;4.2\%)$, an EBRT dose to the parametrium over 55 Gy $(22.1\%\;vs.\;5.1\%)$ and higher stages of III and IV $(31.8\%\;vs.\;10.5\%)$. In the multivariate analysis, the icruCRBED was the only significant factor (p>0.0432). The total parametrial dose from the EBRT had borderline significance (p=0.0546). Grade 1 bleeding was controlled without further management (3 patients), or with sucralfate enema 1 to 2 months after treatment. For grade 2 bleeding, sucralfate enema for 1 to 2 months reduced the frequency or amount of bleeding but for residual bleeding, additional coagulation was peformed, where immediate cessation of bleeding was achieved (symptom duration of 3 to 10 months). Grade 3 bleeding lasted for 1 year even with multiple transfusions and coagulations. Conclusion : Moderate and several rectal bleeding occurred in $8.5\%$ of patients, which is comparable with other reports. The most significant risk factor for rectal bleeding was the accumulated dose to the rectum (icruCRBED), which corrected with consideration to biological equivalence. Prompt management of rectal bleeding, with a combination of sucralfate enema and coagulation, reduced the duration of the symptom, and minimized the anxiety/discomfort of patients.

Environmental Interpretation on soil mass movement spot and disaster dangerous site for precautionary measures -in Peong Chang Area- (산사태발생지(山沙汰發生地)와 피해위험지(被害危險地)의 환경학적(環境學的) 해석(解析)과 예방대책(豫防對策) -평창지구(平昌地區)를 중심(中心)으로-)

  • Ma, Sang Kyu
    • Journal of Korean Society of Forest Science
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    • v.45 no.1
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    • pp.11-25
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    • 1979
  • There was much mass movement at many different mountain side of Peong Chang area in Kwangwon province by the influence of heavy rainfall through August/4 5, 1979. This study have done with the fact observed through the field survey and the information of the former researchers. The results are as follows; 1. Heavy rainfall area with more than 200mm per day and more than 60mm per hour as maximum rainfall during past 6 years, are distributed in the western side of the connecting line through Hoeng Seong, Weonju, Yeongdong, Muju, Namweon and Suncheon, and of the southern sea side of KeongsangNam-do. The heavy rain fan reason in the above area seems to be influenced by the mouktam range and moving direction of depression. 2. Peak point of heavy rainfall distribution always happen during the night time and seems to cause directly mass movement and serious damage. 3. Soil mass movement in Peongchang break out from the course sandy loam soil of granite group and the clay soil of lime stone and shale. Earth have moved along the surface of both bedrock or also the hardpan in case of the lime stone area. 4. Infiltration seems to be rapid on the both bedrock soil, the former is by the soil texture and the latter is by the crumb structure, high humus content and dense root system in surface soil. 5. Topographic pattern of mass movement spot is mostly the concave slope at the valley head or at the upper part of middle slope which run-off can easily come together from the surrounding slope. Soil profile of mass movement spot has wet soil in the lime stone area and loose or deep soil in the granite area. 6. Dominant slope degree of the soil mass movement site has steep slope, mostly, more than 25 degree and slope position that start mass movement is mostly in the range of the middle slope line to ridge line. 7. Vegetation status of soil mass movement area are mostly fire field agriculture area, it's abandoned grass land, young plantation made on the fire field poor forest of the erosion control site and non forest land composed mainly grass and shrubs. Very rare earth sliding can be found in the big tree stands but mostly from the thin soil site on the un-weatherd bed rock. 8. Dangerous condition of soil mass movement and land sliding seems to be estimated by the several environmental factors, namely, vegetation cover, slope degree, slope shape and position, bed rock and soil profile characteristics etc. 9. House break down are mostly happen on the following site, namely, colluvial cone and fan, talus, foot area of concave slope and small terrace or colluvial soil between valley and at the small river side Dangerous house from mass movement could be interpreted by the aerial photo with reference of the surrounding site condition of house and village in the mountain area 10. As a counter plan for the prevention of mass movement damage the technics of it's risk diagnosis and the field survey should be done, and the mass movement control of prevention should be started with the goverment support as soon as possible. The precautionary measures of house and village protection from mass movement damage should be made and executed and considered the protecting forest making around the house and village. 11. Dangerous or safety of house and village from mass movement and flood damage will be indentified and informed to the village people of mountain area through the forest extension work. 12. Clear cutting activity on the steep granite site, fire field making on the steep slope, house or village construction on the dangerous site and fuel collection in the eroded forest or the steep forest land should be surely prohibited When making the management plan the mass movement, soil erosion and flood problem will be concidered and also included the prevention method of disaster.

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Outer Space Activities and an Observation of Related Laws of Korea (국내 우주활동과 관련법 소고)

  • Park, Won-Hwa
    • The Korean Journal of Air & Space Law and Policy
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    • v.24 no.2
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    • pp.163-186
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    • 2009
  • The missile technology and its development in south Korea have been restrained to the limit of 180 km by America which instead provided to Korea with security protection. In the same vein, America pressured South Korea to abort its nuclear weapons program so as to prevent another possible military encounter that can easily develop into a war between South and North Korea. This restraint was a bit relaxed when South Korea joined the Missile Technology Control Regime (MTCR) in 2001 whereby the limit was 300 km. The situation of South Korea is in much contrast with its neighbor, North Korea, which has fired Taepo Dong 1 and Taepo Dong 2 to put its alleged satellite respectively into the Earth orbit. The range of this rocket believed to be reaching more than 5,500 km, a range of the intercontinental ballistic missile, without any rein. South Korea that has just geared its full powers for its outer space industry, with the current space projects of putting its satellites into the low Earth orbit, will in future put its satellite into the geostationary orbit, 36,000 km above the Earth. To do so, such restraint had better be resolved. Korean space industry, as it is alike in other countries, started with putting and manufacturing sounding rockets, producing satellites but relying on foreign launching facilities, and learning launching capacities. Experiencing three time launchings of KITSAT, the current satellite projects of Korea are undertaken as follows: - Koreasat - STSAT - Komsat - MBSAT - COMS (Communication, Ocean, and Meteorological Satellite) Koreans waked up to the things of outer space in 2008 with the first Korean astronaut Li So-yeon, a lady bio systems engineer. Although the first Korean made rocket in cooperation with a Russian company to fire last August 2009 was a failure, it should be considered as an inevitable process for future endeavors. There are currently three outer space related laws of Korea: Aerospace Industry Development Promotion Act 1987, Outer Space Development Promotions Act 2005, and Space Damage Compensation Act 2008. The first two stemming from the two different ministries are, however, overlapping in many aspects and have some shortcomings to be improved.

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A study on the school health education curriculum development focused on the health education course in primary school (국민학교 보건교육 교과과정의 개선방안에 대한 연구)

  • Kim, Hwa-Joong;Lee, In-Sook
    • Journal of the Korean Society of School Health
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    • v.5 no.1
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    • pp.36-63
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    • 1992
  • The purpose of this study was development of school health education curriculum in primary school based on analysis of the textbooks published in 1991. 1) The health education curriculum in primary school consisted of four major components such as health education aspects of the healthful school environments, health education aspects of school health services, health education course, and health instruction in related subjects. However, health instruction taught by physical education, biology, and other health related subjects was not systematic organization for health care. 2) A considerable amount of health knowledge and attitude, and some health practices was learned as the result of experiences in other courses, where there was little or no reference to health. It must be developed health edcation course separated from health related subjects. 3) Direct health insruction was represented by the health education course. The health education courses must be considered to be heart of the school health education curriculum. 4) The health education course developed by this study was consisted of eight health units and problems in the early elementary grade or health classes in the higher years. 5) The health education course developed by this study provided the opportunity for acquring new knowledge, attitude, and practice, for discarding the unhealtful attitude and strengthening the healthful attitude and practices of primary school students.

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The Risk Factors Influencing the Postoperative Mortality of the Patients with an Abdominal Aortic Aneurysm (복부대동맥류 환자에서의 수술 후 사망의 위험인자 분석)

  • Lee, Seong-Kwang;Jun, Hee-Jae;Park, Kyung-Taek;Yoon, Young-Chul;Han, IL-Yong;Lee, Yang-Haeng;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.655-662
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    • 2010
  • Background: Despite the rapid expansion of percutaneous endovascular repair, open surgical repair is still recognized as an option to achieve a cure. We retrospectively analyzed over a 6 year period the surgical outcomes, the complications and the mortality-related factors for patients with abdominal aortic aneurysms. Material and Method: We analyzed 36 patients who underwent surgery for abdominal aortic aneurysms between May 2001 and June 2005, and between April 2007 and November 2009. The indications for surgery were rupture, a maximal aortic diameter > 50 mm, and medically intractable hypertension or pain. Result: The mean patient age was $69.67{\pm}6.97$ years (range: 57 to 84 years). Thirty two patients (88.9%) were males and 4 patients (11.1%) were females. Extension to the iliac artery existed in 28 patients (77.8%). Thirteen patients (36.1%) had ruptured aortic aneurysms. The mean maximal diameter of the aorta was $73.7{\pm}13.3$ mm (60 to 100 mm). Surgery was performed by a midline laparotomy and 10 patients (27.8%) underwent emergency surgery. The mortality rate was 8.3%; the mortality rate for the patients with ruptured aneurysms was 23.1 % and the mortality rate for patients with unruptured aneurysms was 0%. The postoperative complications included wound infection (3 cases), sepsis (2 cases), renal failure (2 cases) and pneumonia (1 case). Unstable vital signs, pre-operative transfusion, ruptured aneurysm, emergency surgery, comorbidity (DM and syncope) and complications (sepsis and renal failure) were the statistically significant mortality-related factors (p < 0.05). Conclusion: Emergency surgery for ruptured aortic aneurysms continues to have high mortality, but the unruptured cases are repaired with relative safety. Even though endovascular aortic repair is the trend for abdominal aortic aneurysms, an elective operation of the unruptured aneurysms could decrease the procedure's morbidity and the inconvenient for repeat evaluation with good surgical results.